Oral Methylprednisolone Acetate (Medrol Tablets) for Seasonal Rhinitis: Examination of Dose and Symptom Response

Abstract

The authors compared the effect of several doses an oral corticosteroid on symptom profile and severity in ragweed hay fever. Thirty-one patients were randomized to receive 0, 6, 12, or 24 mg methylprednisolone (Medrol Tablets [MP], Upjohn, Kalamazoo, MI). A baseline week in which no treatment was given preceded the treatment comparison. At the end of this week, symptom diaries showed that most of the subjects were experiencing moderate or severe symptoms. The corticoid produced dose-related reduction in all symptoms. The difference between placebo and 24 mg MP was significant for all the symptoms monitored, except itching, which benefited marginally. With 6 mg MP, congestion, drainage, and eye symptoms showed significant drug-placebo differences but itching, running/blowing, and sneezing did not. Not all rhinitis symptoms responded equally to corticoid treatment. Those that responded least could reflect histamine effect, which was not effectively suppressed by low-dose, short-term corticoid treatment.

The Effect of Gencydo® Injections on Hayfever Symptoms: A Therapeutic Causality Report

“…This possibility certainly cannot be excluded, but it does not seem likely that this contributed significantly to the ultimate effect. The study used the same symptom score questionnaire, 4 which has often been used in clinical studies with good results.…”

“…4 This questionnaire was completed each morning and evening, noting the following items: nasal (blocked nose, itchy nose, sneezing or a runny nose) and nonnasal symptoms (itchy/ burning eyes, watery eyes, redness around the eyes, itchy ears/ palate) on a 4-point scale (0 ϭ none, 1 ϭ mild, 2 ϭ strong, and 3 ϭ severe). Both total nasal score (TNS) and total nonnasal score (TNNS) could vary between 0 and 12.…”

Mechanisms and clinical implications of glucocorticosteroids in the treatment of allergic rhinitis

“…In addition, evidence regarding a suitable dosage of this drug is lacking. Among oral GC, only methylprednisolone tablets are confirmed as an effective treatment for allergic rhinitis by a placebocontrolled trial; this trial showed that a daily dosage of 24 mg of methylprednisolone was necessary to obtain a significant improvement in all nasal symptoms [81]. Thus, the use of oral GC corresponding to 20-30 mg of prednisolone should be limited to a brief period of time (within 1 week) when treating patients with allergic rhinitis.…”

Consensus statement * on the treatment of allergic rhinitis

“…The only controlled comparison between oral and injected steroids in rhinitis showed a therapeutic index in favour of the depot injection ( 118). Nevertheless, there are arguments in favour of oral administration ( 119). It is cheap, and the dosage can be adjusted to the changing need for treatment.…”